Tag

Healthcare Policy

All articles tagged with #healthcare policy

health11 days ago•11 min saved

Medicare rolls out temporary obesity-drug coverage via Bridge program with $50 copay

Medicare will temporarily cover obesity GLP-1 medications under the Bridge program starting July 1, with a flat $50 monthly copay for eligible Part D beneficiaries and no deductible contribution toward costs. Drugs like Wegovy and Zepbound are included, and eligibility is based on BMI thresholds and related health conditions; the coverage runs through an 18-month demonstration ending in 2027 unless extended, with prior-authorization handled by providers and Humana. While the move could unlock millions of potential patients for Novo Nordisk and Lilly, concerns include surge in demand, administrative burden, and the uncertain long-term viability beyond the demonstration, as well as ongoing policy debates such as Balance and the Treat and Reduce Obesity Act.

via CNBC|

#bridge-program #glp-1 #health

health11 days ago•99 min saved

Japan's pay-for-not-prescribing antibiotics shows promise; could the US copy it?

Japan’s national effort to curb antibiotic resistance includes an incentive that pays pediatricians about 800 yen (~$5) when they don’t prescribe antibiotics for illnesses likely caused by viruses. Rolled out in 2018 and later expanded to more clinics and conditions, the program reduced total antibiotic use in eligible clinics by about 17.8% in the first year and lowered broad-spectrum prescriptions by 20–24% over four years, without raising hospitalizations. The piece questions whether the US could adopt a similar approach and explores drivers of doctors’ prescribing decisions and cultural factors that influence such policies.

via Live Science|

#antibiotic-stewardship #antimicrobial-resistance #health

health1 month ago•12 min saved

UnitedHealthcare trims prior authorizations for most pediatric care

UnitedHealthcare will drop prior authorization for about two-thirds of pediatric services for members under 18, including many diagnostic tests, routine surgeries and subspecialty care, with authorization waivers for select procedures at leading pediatric hospitals. The move is meant to cut delays and paperwork; the insurer is conducting a data-driven review and aims to have over half of authorizations standardized by year’s end, with more than 70% incorporated into the new process, per CEO Tim Noel.

via KSL.com|

#health #healthcare-policy #insurance

healthcare1 month ago•33 min saved

UHC streamlines pediatric care by scrapping prior approvals on two-thirds of services

UnitedHealthcare will remove prior authorization requirements for about two-thirds of pediatric services, aiming to speed access to care and reduce administrative burden for families and providers; the article excerpt does not specify the exact services affected or the implementation timeline.

via Yahoo|

#healthcare #healthcare-policy #insurance

healthcare1 month ago•3 min saved

TrumpRx.gov Expansion Opens Transparent, Discounted Generics for Americans

President Trump announced an expansion of TrumpRx.gov to list more than 600 generic medications with transparent cash prices, enabling patients to compare the best cash prices at local pharmacies or delivery options against insurance co-pays, and integrating discounts from Amazon Pharmacy, Cost Plus Drugs, and GoodRx; the platform excludes controlled substances and meds not commonly offered direct-to-consumer, building on prior executive actions to lower US drug costs.

via The White House (.gov)|

#drug-pricing #generic-meds #healthcare

healthcare-policy1 month ago•2 min saved

Oz launches 29-member coalition to speed medical prior authorizations

Dr. Oz unveiled a 29-member coalition of insurers, hospitals, and health-records companies to streamline prior authorization for medical procedures, aiming for faster, more transparent decisions by next January. The move expands a trend of insurer pledges to reduce administrative burden, with groups like AtlantiCare, Bon Secours Mercy Health, and Cleveland Clinic on board. Medicare’s AI-powered pre-treatment reviews have begun in some states, while critics warn about persistent paperwork and calls in Congress to curb prior authorizations for Medicare Advantage. The effort signals ongoing pressure to simplify and standardize the process across providers and payers.

via Axios|

#cms #dr-oz #electronic-prior-authorization

business2 months ago•4 min saved

UnitedHealth to Slash Pre-Authorization Hurdle with AI-Driven Approvals

UnitedHealth said it will stop requiring approvals for a range of tests, surgeries and therapies, using AI to automate or eliminate prior authorizations for items like echocardiograms and certain outpatient services. The move aims to cut required authorizations by nearly a third this year and speed access to care, noting that prior authorizations currently apply to about 2% of services and most approvals occur within 24 hours. The policy shift signals how AI could reshape the financial side of healthcare across Medicare, Medicaid and employer plans.

via New York Post|

#ai-in-healthcare #business #health-insurance

healthcare2 months ago•2 min saved

UnitedHealthcare to drop prior authorization for 30% of services by 2026

UnitedHealthcare will eliminate prior authorization for about 30% of medical services that previously required insurer approval, including select outpatient surgeries, certain diagnostic tests (e.g., echocardiograms), some outpatient therapies, and some chiropractic care, with the change to take effect by the end of 2026. The company notes that prior authorization currently applies to about 2% of services and 92% are approved within 24 hours, while critics say the process creates administrative burdens and delays care; the move aligns with broader industry pressure to streamline authorization across insurers.

via CBS News|

#health-insurance #healthcare #healthcare-policy

health2 months ago•6 min saved

Alzheimer’s Advances Won’t Help Without Diagnosis and Funding

Alzheimer’s breakthroughs are advancing scientifically, with drugs like Lecanemab and Donanemab showing amyloid removal and slowed decline, but experts say real progress hinges on better, earlier diagnosis through biomarkers and genetics, plus sustained political investment in dementia services to ensure access and implementation across healthcare systems.

via WIRED|

#alzheimers #biomarkers #dementia

healthcare-policy2 months ago•6 min saved

Court halts federal bid to ban pediatric gender-affirming care, boosting access

A federal judge in Oregon overturned the Trump-era effort to bar gender-affirming care for minors under HHS policies associated with RFK Jr., ruling the move unlawful and blocking similar nationwide enforcement. The decision removes the immediate threat to federal funding and allows many providers to resume care, though state bans and access gaps remain in some areas.

via The Guardian|

#court-ruling #gender-affirming-care #healthcare-policy

politics3 months ago•4 min saved

Bipartisan Deal Seeks $35 Insulin Cap With Uninsured Pilot

A bipartisan group of senators led by Jeanne Shaheen announced a deal to cap the price of insulin at $35 per month, including a pilot program in 10 states for the uninsured and changes to rebate programs for pharmacy benefit managers; the plan would be attached to other must-pass legislation, and still requires buy-in from Senate leadership and the president to move forward.

via Semafor|

#bipartisan #healthcare-policy #insulin

politics3 months ago•1 min saved

Judge blocks federal plan to curb transgender youth care, upholding state protections

A federal judge in Oregon is set to grant Washington and 20 other states’ motion for summary judgment, blocking a Trump-era Health and Human Services directive that would pressure providers to stop treating transgender youth and threatened to exclude them from Medicaid/Medicare. The judge said the declaration exceeded statutory authority and bypassed required rulemaking, and, once formalized, the ruling would preserve access to gender-affirming care for transgender youth in the involved states.

via KOMO|

#federal-government #healthcare-policy #judiciary

healthcare4 months ago•7 min saved

TrumpRx Promises Grand Savings, Delivers Narrow Drug List After One Month

One month after its launch, TrumpRx has only a small catalog of drugs (44 listed) despite lofty promises of broad discounts, with many items already available as generics and no clear usage data released. Private deals with drugmakers remain in flux, limiting impact on prices, while administration officials trumpet progress amid bipartisan scrutiny and questions about affordability gains for most patients.

via statnews.com|

#drug-pricing #generics #healthcare

health4 months ago•1 min saved

States Tighten HIV Drug Aid as Costs Rise and Federal Support Falls

Nearly 20 states are tightening eligibility for Ryan White HIV/AIDS Drug Assistance Programs as costs rise and federal support wanes, limiting access to HIV medications; Florida exemplifies the trend by cutting thousands off benefits and dropping Biktarvy from its formulary.

via The New York Times|

#adap #funding #health

health4 months ago•5 min saved

Poll finds UK women largely unaware menopause can trigger mental illness, prompting calls for action

A YouGov poll of over 20,000 psychiatrists shows about 75% of UK women don’t know menopause can trigger a new mental illness, leading the Royal College of Psychiatrists to publish a position statement urging better awareness, training, and policy action. The report notes perimenopause doubles the risk of bipolar disorder and increases clinical depression risk, with associated misdiagnosis and anxiety; it also highlights gaps in care, calls for workforce and workplace support, NHS investment, and more research. Personal stories underscore diagnostic delays and the impact on women’s mental health.

via The Guardian|

#health #healthcare-policy #menopause